Coccidioidomycosis (Valley fever) is a systemic fungal infection endemic to the southwestern United States. Incidence has risen in the past decade, with more than 100,000 cases diagnosed annually. This case study discusses a 46-year-old male who presented to the author's outpatient urology clinic in central California with painful left scrotal swelling and who was eventually diagnosed with testicular coccidioidomycosis. While testicular coccidioidomycosis is not common, the case is presented because consideration as a differential diagnosis for scrotal masses or lesions in patients who live in endemic areas is essential.